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Di Indonesia kanker payudara merupakan kanker tertinggi yang banyak datang pada stadium lanjut sehingga berdampak terhadap mortalitas dan tingginya pembiayaan. Mammografi merupakan alat skrining dan diagnosis yang sudah terbukti efektifitasnya menghasilkan “down staging” pada negara maju, Indonesia sebagai negara berkembang belum menjadikan skrining mammografi sebagai program nasional. Dilakukan studi parsial evaluasi ekonomi biaya dan luaran dengan membandingkan mammografi untuk skrining berbasis populasi terhadap oportunistik skrining di RS. Dilakukan uji coba skrining berbasis populasi terhadap 683 wanita dengan menggunakan mobil mammografi hingga didapatkan case detected serta diambil data retrospektif pasien deteksi dini dengan mammografi hingga penegakan diagnosis di RS dalam periode satu tahun. Dilakukan analisis biaya berdasarkan perspektif program dengan analisis luaran case detected. Didapatkan unit cost pemeriksaan skrining adalah Rp871,045. dengan case detected 0,4% dan cost per case detected Rp Rp290,348,509. Pada deteksi dini di RS didapakan unit cost Rp1,137,881 dan 3% kasus positif kanker. Terhadap skrining berbasis populasi, untuk mendapatkan satu kasus positif kanker diperlukan biaya sebesar Rp 262.342.333. Dengan sumber daya yang dimiliki perlu dilakukan inovasi dalam deteksi dini mammografi melalui penguatan pelaksanaan skrining CBE sebagai program nasional didukung pendekatan akses melalui diagnosis dini dengan mobil mammografi terutama di daerah rentan sehingga dihasilkan diagnosis secara cepat dan tepat dan biaya yang murah. Diperlukan peran pemerintah melalui pembiayaan yang berkelanjutan terhadap deteksi dini mammografi untuk dapat menurunkan angka mortalitas dan pembiyaan dalam pengobatan kanker. Kata kunci: Kanker payudara, mammografi, cost and outcome.
Breast cancer is the highest cancer in Indonesia that come at late stage so have impact on mortality and high funding. Mammography is a screening and diagnosis that has proven its effectiveness in producing "down staging" in developed countries, Indonesia as a developing country has not made mammography screening a national program. A partial study of economic evaluation of costs and outcomes was conducted by comparing mammography for population-based screening to opportunistic screening in hospitals. A population-based screening was conducted on 683 women using a mobile mammography until a case was detected and retrospective data taken from early detection patients with mammography to diagnose the hospital in a period of one year. A cost analysis is carried out based on the program perspective with a case detected output analysis. The unit cost of screening is Rp.871,045. with case detected 0.4% and cost per case detected Rp.290,348,509. At early detection in the hospital unit unit costs are obtained Rp1,137,881 and 3% of positive cases of cancer. For population-based screening, to get one positive case of cancer costs Rp 262,342,333. With the available resources, innovation in the early detection of mammography needs to be done through strengthening the implementation of CBE screening as a national program supported by an access approach through early diagnosis by mammography cars, especially in vulnerable areas so that diagnosis is produced quickly and accurately and at a low cost. The role of government is needed through ongoing financing of early detection of mammography to be able to reduce mortality and financing in the treatment of cancer. Keywords: Breast cancer, mammography, cost and outcome